AIDS – Anorexia Nervosa
AIDS stands for acquired immune deficiency syndrome. AIDS is a
disease that causes people to suffer from opportunistic infections,
which are serious infections caused by germs to which healthy people are
resistant.
The human immunodeficiency virus (HIV) is the cause of AIDS. A person
who has the human immunodeficiency virus is said to be HIV positive.
People with AIDS related complex, or ARC, are HIV positive and have some
symptoms, but do not have fullblown AIDS. AIDS in some cases is not
preceded by ARC. The number of people who will develop ARC or AIDS
because they are HIV positive is not known.
AIDS is one of the least transmittable communicable diseases of
childhood. HIV is spread through transfusion of contaminated blood, use
of contaminated hypodermic needles, or intimate sexual contact with a
person who has the disease. It can also be transmitted from mother to
baby while the baby is in the womb. In recent years, the blood supply
has, for the most part, been made safe from HIV transmission.
In school, children with AIDS need no routine quarantine or isolation,
although they may be exposed to germs that can cause opportunistic
infections. Exclusion of a child with AIDS from day care is dependent
upon how well the child can control secretions and the circumstances of
the day-care facility. s.w.
Albinism is the absence of a pigment or coloring (melanin), in the
skin, eyes, and hair. This inherited disorder results when a child lacks
the enzyme needed to produce normal skin pigment. Albinism may be total
or partial. In total albinism, the child’s skin
and hair are milk-white or platinum colored. The child’s eyes are
extremely sensitive to light, and the pupil and iris have a pinkish
color. The eyes are weak and may also waver from side to side in a
searching motion.
A child with partial albinism may have white skin patches that are
usually present at birth. The child might have a triangular- or
diamond-shaped white patch on the forehead and a streak of white hair
immediately above the forehead. In ocular albinism, the pigmentary
defect is confined to the eyes.
There is no specific treatment for albinism. An albino child may wear
tinted eyeglasses if the eyes are sensitive. The child should wear
proper clothing to protect the skin and sunglasses to protect the eyes
from excessive exposure to sunlight, [m.g.]
Allergy is an abnormal reaction to substances that are neither
harmful nor infectious to most people. Children of parents who are
allergic inherit the tendency to become allergic, but do not necessarily
inherit the same allergy that the parents suffer.
Substances that cause allergic reactions are called allergens. They
include foods, drags, pollens, airborne mold spores, animal dander
(particles from hair, feathers, or skin), household dust, bacteria,
viruses, parasites, and other substances. Light, heat, and cold may also
cause allergic reactions. Emotional factors aggravate allergies. A
doctor will take these factors into consideration when treating a child
who suffers from such allergic diseases as hives, eczema, or asthma.
Allergens may enter the body by being inhaled, eaten, drank, touched, or
injected. When they enter the body, the allergic person develops
antibodies. The interaction of the allergens and the antibodies releases
histamines and other chemical substances that circulate throughout the
body and cause allergic symptoms.
Allergic symptoms may occur in any part of the body. When they occur in
the respiratory tract, the child may appear to have a cold. The child
sneezes and has a runny or stopped-up nose, or wheezes, coughs, and
has trouble breathing. When allergic symptoms appear in the skin, the
child may have a rash or wheals (flat, hard ridges on the skin that
usually itch). When symptoms occur in the central nervous system, the
child may be irritable and have headaches or seizures. When they occur
in the gastrointestinal tract, the child may have cramps, nausea,
vomiting, or diarrhea. These reactions are often completely reversible
so that no permanent damage results. Doctors often prescribe
antihistamines and other drugs to relieve symptoms.
An allergy may develop at any time during a person’s life. It usually
develops gradually. At first, the body does not react to the substances.
But, as exposure continues, an allergy results. Doctors do not know why
one child develops an allergy to a substance that is harmless to another
child.
Common allergies. Four common allergic diseases that children
develop are asthma, eczema, hay fever, and hives.
Asthma affects the bronchial tubes. Common symptoms are coughing,
wheezing, and labored breathing. These often worsen with exertion. The
coughing commonly occurs at night. In children older than 9 months, the
wheezing usually occurs when they exhale. In infants, the labored
breathing is rapid and the child seems short of breath. Children 3 years
old or older also feel tightness in the chest, or breathlessness. Common
causes of asthma are airborne allergens and respiratory infections.
Eczema is a rash that occurs in patches on the skin and itches
intensely. The patches may be red and oozing or crusty. Or they may be
thickened, dry, and scaly. Foods, drugs, inhalants, and allergens that
touch the skin are common causes.
Symptoms of hay fever include sneezing, stuffiness or blockage of the
nose, runny nose, watering of the eyes, and itching of the eyes, nose,
ears, and the roof of the mouth. Pollens, airborne molds, and house dust
are usually responsible for hay fever.
Hives are raised, whitish wheals with reddened edges. The wheals usually
itch. Food, drugs, and insect bites are common causes of acute (sudden
and severe) hives.
Some children’s allergies improve as the child grows older. Other
children develop
complications and become worse. About one half of all allergic adults
developed allergies before they were 11 years old. If you think your
child has an allergy, consult the doctor. Treatment depends on the
severity of the symptoms.
Determining allergies. A doctor begins the search for the cause of
an allergy by compiling a detailed history of the illness, especially
the events preceding the first attack. The doctor tries to relate the
symptoms to foods, substances inside and outside the home, the time of
day, the season, and other factors. Usually a doctor can determine the
possible allergen through this history. The doctor will then prescribe
removing the suspected allergen from the child’s diet or environment in
order to determine if the substance is causing the reaction. For
example, a child who coughs when going to bed and for a short time in
the morning may stop coughing when a feather pillow or down comforter is
replaced with one filled with synthetic fibers.
Unfortunately, treatment is sometimes complex. Often allergic symptoms
are caused by a combination of several allergens. Also, house dust,
animal dander, and airborne molds may be persistent factors. The attack
may also be triggered by infections, emotional upsets, weather changes,
or simply an overload of allergens.
Skin tests help identify possible allergens. These tests are simple and
can usually be done in one or two sessions:
Using the prick test, the doctor makes small, light pricks, usually
on the child’s arms. With each prick, the doctor places a small
amount of a suspected allergen. If the child is allergic to a
substance on a test area, that area becomes red, swollen, and itchy.In another method of testing, the doctor injects a small amount of
the possible allergen under the child’s skin and waits about 10 to
20 minutes for a reaction.With an infant covered with eczema, or with a highly emotional older
child, the doctor may use the indirect, or enzyme assay, method. A
blood sample is taken from the child and, after preparation, it is
tested in an allergist’s laboratory. When monoclonal antibodies are
used, results can usually be
Doctors sometimes use patch tests to determine if a child is allergic
to a substance upon contact. Possible allergens are placed on unbroken
skin, covered, and left touching the skin. These pictures show two
different reactions. The one on the left is moderately severe, the one
on the right is very severe.
determined and interpreted for the patient or parents in less than two
days.
- In the patch test, the doctor places the possible allergens on
unbroken skin and covers them, usually for 48 hours, to determine
what substances may produce an allergic reaction upon contact.
Skin tests may be useful, although their uses are limited. There is no
correlation between the size of the reaction and the child’s
sensitivity. And not every positive skin test is significant, because
irritants such as tobacco, cow hair, mustard, cottonseed oil, and
spinach can cause false positive tests. Also, with few exceptions, food
allergies are not reliably detected. The food may cause an allergic
reaction only after it has been altered by digestion. Consequently,
foods are often tested through a controlled diet as well. Avoiding the
suspected food allergen should bring relief from allergic symptoms.
Including it again in the diet should produce the symptoms. Eggs, fish,
nuts, beans (which include peanuts), pork, and milk are common food
allergens.
Treatment. Doctors may treat allergic disorders such as hay fever
and asthma with a series of shots over a period of years. Repeated
injections of gradually increasing doses of the responsible inhaled
allergens help build up resistance to these allergens.
Doctors usually treat an allergy by eliminating the allergen from the
child’s surroundings. For instance, it may be necessary to remove a dog
or cat, feather pillows, or wall-to-wall carpeting from the child’s
home, because otherwise immunization is generally ineffective.
When a particular food is the allergen, the doctor may suggest
eliminating it from the child’s diet. For example, if milk is the
allergen, all foods that contain milk—such as ice cream, cheese, and
butter—must be eliminated. Immunization against food allergens is not
practical, because there is no proof yet that it is effective.
In rare instances a child is so allergic to the venom of bees, wasps,
yellow jackets, hornets, spiders, or ants that a serious or fatal
reaction may result from a sting or
bite. Such an allergic child should have a special medical kit for
emergency treatment if bitten or stung. The doctor may advise shots to
desensitize the child to insect venom.
If your child suffers from a respiratory allergy, your doctor may also
suggest some of the following procedures to help reduce airborne
allergens in your home and make the child’s bedroom as dust-free as
possible: ■ Use an air conditioner that filters out pollen and decreases
humidity.
Eliminate wall-to-wall carpeting, stuffed toys, upholstered
furniture, and feather pillows from the child’s room.Enclose the child’s mattress and box spring in a zippered,
allergen-proof cover to prevent dust from escaping into the air.Do not keep pets that have either fur or feathers.
Do not use Venetian blinds, curtains, bookcases, or upholstered
furniture, or keep plush animals and other dust-collecting objects
in the child’s room.Avoid smoking in the house or automobile, because smoke irritates
the mucous membranes in the respiratory tract.
Children who are extremely sensitive to certain foods or drugs should
wear a warning bracelet or necklace bearing this information. A bracelet
may be purchased from the Medic Alert Foundation through your pharmacy.
Preventing allergic reactions. If you have a strong family history
of allergy, consult your doctor to attempt to prevent allergies in your
child. The doctor may recommend breast-feeding or starting your infant
on prepared milk formula or cow’s milk substitutes. The doctor may also
recommend that you introduce new foods slowly, and that you not give the
baby food of high allergy potential, such as uncooked cow’s milk, eggs,
and wheat, until the infant is 10 to 12 months old. [j.sh.]
See also Asthma; Eczema; Hay fever; Hives
Anemia is a condition that results from a reduction in the number of
red blood cells, or a reduction in the amount of hemoglobin in the red
blood cells. Hemoglobin is made
up of iron and protein and gives the red color to red blood cells. The
hemoglobin in the red blood cells picks up oxygen from the air that a
child breathes into the lungs and carries the oxygen to all body tissue.
When either the number of red blood cells or the amount of hemoglobin in
these blood cells is reduced by anemia, the child’s body does not
receive enough oxygen and does not function properly.
In some mild cases of anemia, the child may not have symptoms. That is
why your pediatrician will routinely screen the child with a blood count
at age-appropriate times. A child with anemia may be pale and may not
feel as energetic and playful as usual. If anemia is severe and comes on
suddenly, the child may be without energy, short of breath, and
critically ill. If you think your child may be anemic, consult your
pediatrician.
The most common cause of anemia is insufficient iron in the child’s
diet. Between the ages of 6 months and a year, a baby who receives only
milk may become anemic, because milk lacks iron. Meats, iron-fortified
cereals, egg yolk, and vegetables are necessary and should be added to
the child’s diet. If iron deficiency anemia occurs, iron may be
prescribed.
Sometimes a child’s diet contains plenty of iron, but the child’s body
does not absorb enough of it. During certain long-lasting diarrheas,
iron is not absorbed by the intestines. The diarrhea must be controlled
before the anemia can be corrected by iron tablets or tonic. In rare
instances, injections of iron may be necessary.
Loss of blood from an injury, from an ulcer, from hemophilia, or from
other bleeding diseases may also cause anemia. This anemia is cured by
stopping the bleeding and, if necessary, by giving the child
transfusions.
Some anemias, called hemolytic anemias, are caused by the destruction of
red blood cells. Hemolytic anemias may be inherited or acquired. Sickle
cell anemia is an inherited hemolytic anemia. Some acquired hemolytic
anemias are caused by sensitivity to certain drugs or plants, r.o.
See also Bleeding; Blood count; Hemophilia; Leukemia; Nutrition
Anesthetics are commonly used to eliminate the feeling of pain.
Doctors usually give them to a child who is having an operation.
There are two kinds of anesthetics—local anesthetics and general
anesthetics. Local anesthetics eliminate pain in a small area of the
body, but they do not cause unconsciousness. The anesthetic is usually
given by injection. Doctors use local anesthetics for such operations as
stitching a cut or pulling a tooth. This is the safest form of
anesthetic, but it can seldom be used for large operations.
General anesthetics eliminate pain over the entire body. They cause
partial or complete unconsciousness. General anesthetics affect the
brain directly and block reception of pain. The most common way to
administer a general anesthetic is to have the child breathe it in the
form of a gas. Intravenous drugs such as sodium pentothal, often used
with older children and adults, are seldom used for infants and young
children.
Before receiving a general anesthetic, a child is not given anything to
eat or drink for several hours. This allows the stomach to empty so that
while unconscious the child won’t vomit and possibly breathe food into
the lungs.
Preanesthesia medications are often (but not always) given thirty
minutes to two hours before an operation to cause drowsiness, relieve
apprehension, and decrease airway secretions. These are given by
injection.
Parents can ease a child’s apprehension before an operation by
explaining the purpose of the surgery, the sequence of events before,
during, and after the operation, and any discomfort involved.
Major operations, and in small children many minor operations, are
carried out under general anesthesia. Administering anesthesia is no
more risky in children than in adults. Even premature, newborn infants
can be safely anesthetized. Prior to an operation, the person who will
give the anesthetic usually explains how it will be done.
Many lesser operations in children are performed under general
anesthesia as an outpatient. After completely awakening from anesthesia,
the child can go home to finish recovering from the operation. This is
quite safe and allows the child to be in the more secure, familiar
surroundings of the home, [t.m.h.]
Anorexia nervosa is an emotional illness. It is an extreme form of
very poor appetite or self-starvation. Anorexia means “without
appetite,” but anorexics may be very hungry much of the time. Anorexia
occurs mainly in adolescent girls and young women. The cause is
emotional or sociocultural.
The condition may begin when the child goes on an extreme diet because
of fear of being fat. This may lead to a refusal to eat, self-induced
vomiting, or laxative abuse after eating. The amount of weight loss may
not be noticed by parents until it is extreme. The patient herself will
have an altered body image—that is, she will see herself as fat— and
will have little concern for her wasting. The condition may be
accompanied by a failure to menstruate.
There is a relentless pursuit of thinness. In spite of the loss of
weight, the child may not only continue normal activities, but also may
exercise quite vigorously. The child maintains an active interest in
food and food preparation. Some patients show signs of depression.
Although anorexia nervosa may be mild, it is generally a severe and
chronic problem. It may even result in death. Children are usually
hospitalized under the care of a physician and a psychiatrist.
See also Appetite; Diets; Overweight; Underweight
Antibiotics. See Drugs
Antidote. See Poisoning and poisons
Antihistamine. See Allergy
